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Focusing on the Smaller Adverse Childhood Experiences The Overlooked Importance of Aces

Dimitri A. Christakis, MD, MPH1,2
[+] Author Affiliations
1Seattle Children’s Research Institute, Seattle, Washington
2Associate Editor, JAMA Pediatrics
JAMA Pediatr. 2016;170(8):725-726. doi:10.1001/jamapediatrics.2016.0392.
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This Viewpoint discusses focusing on the smaller adverse childhood experiences that come from suboptimal or misguided parenting.

At the turn of the 19th century, Wordsworth succinctly articulated what many developmental psychologists have gone on to prove. Our childhood determines what kind of person we become. His idyllic vision of childhood was bucolic frolicking in the hills of Tintern abbey. But the reality for many children is quite different: Abuse, neglect, parental substance abuse, and divorce are part of many children’s early experiences, enough so that we have developed an acronym for them. Adverse Childhood Experiences (ACEs) have been well described as precursors to children’s short- and long-term untoward functional outcomes. Estimates are that about 12% of children experience 4 or more of them.1 A growing body of evidence has documented the negative health implications of ACEs. In longitudinal studies, ACEs have been shown to be associated with increased risk of alcoholism, depression, smoking, obesity, and substance abuse among other things.1 Preventing ACEs or mitigating their effects is therefore an important public health issue.


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